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Subclinical autonomic disturbances in multiple sclerosis
D Linden1, R R Diehl, P Berlit
1Department of Neurology and Clinical Neurophysiology, Alfried Krupp Hospital, Essen, Germany.
Journal of Neurology
|June 1, 1995
Summary
Sympathetic skin responses (SSR) show high diagnostic yield in multiple sclerosis, correlating with motor and somatosensory evoked potentials. This non-invasive test may aid in diagnosing this neurological condition.
Area of Science:
- Neurology
- Autonomic Neuroscience
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
- Autonomic dysfunction is increasingly recognized in MS, impacting patient quality of life.
Purpose of the Study:
- To evaluate the diagnostic utility of non-invasive autonomic testing, specifically sympathetic skin responses (SSR), in patients with multiple sclerosis (MS).
- To compare SSR results with established neurophysiological markers like motor evoked potentials (MEP) and somatosensory evoked potentials (SEP).
Main Methods:
- Compared SSR, heart rate variability during deep breathing, and orthostatic maneuvers with transcranial Doppler monitoring in 22 MS patients.
- Assessed MEP and SEP in 30 unselected MS patients.
- Analyzed correlations between SSR, MEP, and SEP across 120 limbs.
Main Results:
- SSR demonstrated a high pathological yield (66.7%), comparable to MEP (65.5%) and SEP (69%).
- SSR showed significant correlation with both MEP and SEP (P < 0.001) across limbs.
- Autonomic testing revealed reduced heart rate variability in 3 patients and cerebral dysautoregulation in 4 patients during orthostatic maneuvers.
Conclusions:
- SSR is a valuable, non-invasive tool for diagnosing multiple sclerosis.
- Cerebral dysautoregulation is a frequent finding in MS patients, though its clinical significance requires further investigation.